Back in 2002 as a doctor

The more director Jiang watched, the more he couldn't understand Zhou Congwen's operation.

The guide wire walked steadily in the mesenteric vein, and the "floating" of the mesenteric vein was not felt at all.

Performing surgery by yourself is like walking a tightrope, and it is a tightrope in a strong wind. Every step is cautious, but the final result of the operation is still a failure.

Zhou Congwen's operation is very simple. He is not walking a tightrope, but a corridor bridge.

The covered bridge was closed all around, no matter how windy it was outside, the road he was on was a flat avenue.

No reason!The little beast in Director Jiang's heart was roaring wildly and violently.

The point is that he doesn't know what technique Zhou Congwen used to make the "floating" and "floating" mesenteric veins so stable and motionless.

Super selection, a one-time success without any surprises.

The catheter was placed in the lower blood vessel with thrombus, at the distal end, Zhou Congwen said, "Prepare urokinase and start thrombolysis."

"..." Director Jiang was silent.

"Huh?" Zhou Congwen was taken aback, "Director Jiang? You don't know how to configure urokinase, do you?"

"..." Director Jiang cried.

"I know." He quickly struggled out of confusion, trying to calm down, and said as calmly as possible, "Xiao Zhou, what then?"

"Inserting a catheter for thrombolysis, I will puncture the femoral artery to dissolve the thrombus in the mesenteric artery."

really!

I am just an assistant!

Still a useless assistant whose function is only to support the guide wire, guide the catheter, and let Zhou Congwen say a few words less!

Director Jiang felt inexplicably sad.

As the director of the vascular department of the Second Hospital of a dignified medical university, he can afford both surgery and vascular intervention.

In the whole province, not to mention the first, he can also be ranked second. Only Director Gou of the First Hospital of the Medical University can compete with him.

Unexpectedly, people who played Zhou Congwen would dislike him.

"Hold the guide wire well. The chance of thrombolysis is better now. If you miss a few more hours, you may have to cut the intestine." After Zhou Congwen finished speaking, he raised his hands up to the chest and came to the patient's leg to start the next procedure. surgery.

Wen Yuan looked very confused, he had no idea how shocking Zhou Congwen's surgery was, and weeping ghosts and gods.

It seems to be a very ordinary and ordinary operation. Zhou Congwen didn't make a single mistake. He was not even nervous during the operation, and he succeeded once.

No matter how floating the blood vessels were, it was like walking on flat ground to Zhou Congwen.

That's it?It seems that there is no difficulty.

But why is Old Jiang so dazed, looking in a bad state?

Wen Yuan caught a glimpse of Zhou Congwen puncturing the femoral artery, hitting the nail on the head, and placing a vascular sheath, so he quietly moved towards the patient's head, and asked in a low voice, "Director Jiang, is Professor Zhou's operation okay?"

"What?" Director Jiang was instructing the roving nurse to dispense thrombolytic drugs, but he didn't hear what Wen Yuan said.

"It can be dissolved."

"I can't and I can't help it. If it can't be dissolved, I'm going to cut the intestines." Director Jiang said.

"..." Wen Yuan was speechless.

Isn't the operation successful? Why do you need to cut the intestines!

"It's okay, Professor Wen." Zhou Congwen crossed his left and right hands, helped himself to guide the wire, and started to superselect steadily, "Director Jiang dare not use too much urokinase, he is worried about bleeding from the liver passage."

"Ah, yes." Director Jiang didn't dare to yell at Zhou Congwen. Hearing what Zhou Congwen said, he quickly admitted his thoughts.

"It's okay, the speed of urokinase can be increased." Zhou Congwen raised his head and narrowed his eyes at Director Jiang.

Director Jiang felt struck by lightning.

It's not because Zhou Congwen is as beautiful as a flower, and Director Jiang fell in love at first sight, but Director Jiang saw Zhou Congwen's left and right hands crossed, and when he raised his head and smiled at himself, he blindly super-selected into the lower blood vessel of the mesenteric artery.

What kind of fairy-level operation is this!

Director Jiang's self-confidence was severely hit, and he felt that he would never have another operation in his life.

Blind selection, that was just a legendary surgical technique, I didn't expect Zhou Congwensui to show it to himself casually.

"Two tubes of medicine are prepared, and the side of the micropump also needs one." Zhou Congwen glanced at the screen and said lightly.

While speaking, the super-selection of the mesenteric artery has been completed, and the micropump is directly connected to start pumping urokinase.

This surgery was done...

Director Jiang didn't know what to say.

The last time I did it for 3 hours, the operation still ended in failure.

While Zhou Congwen was performing the operation while talking, he started thrombolysis in less than 10 minutes.

Originally, Director Jiang realized that his level was higher than his own when he and Zhou Congwen were performing Budd-Chiari syndrome surgery in the Third Hospital, but after careful consideration after returning home, it seemed that he was only a little higher.

And with the passage of time, every time Director Jiang thought of Zhou Congwen, he felt that his level was indeed higher than his own, but the range was limited.

As long as his condition is a little better, as long as he is a little bit better, he can beat Zhou Congwen.

The operation in front of him clearly told Director Jiang that the gap between the two was completely unimaginable.

Zhou Congwen didn't use all his strength at all, and he was not in a hurry for the operation. He did it "slowly".

"Okay, wait a minute." Zhou Congwen connected the micropump and said with a smile, "Professor Wen, pay attention to the color of the intestinal tract, and let me know if the color changes in a while."

"Oh, oh, huh? Will it change?" Wen Yuan was already in a daze, not knowing what Zhou Congwen was talking about.

"The color doesn't change, what are we messing with here?" Zhou Congwen said with eyes wide open, "Don't worry, the radiography should not involve the removal of the intestinal tract now, I guess it can be dissolved."

"..." Wen Yuan's heart was full of mixed feelings, and he didn't know how to describe it.

"Director Jiang, the speed of the micropump on your side can be higher." Zhou Congwen continued.

"Huh? It's already very high. If it is higher, the liver will bleed, and it will still be troublesome." Director Jiang insisted, not daring to increase the dose any further.

As a surgeon, Director Jiang has his own clinical experience. Zhou Congwen's words have violated the basic clinical principles, and he has no blind faith.

Chapter 0645

"The effect of this dose of thrombolysis is relatively poor. Whether it can dissolve depends on fate." Zhou Congwen said, "Increase the dose, it's fine, don't worry, Director Jiang."

Director Jiang still hesitated.

"Xiao Zhou, what should I do if I bleed?" He cautiously "asked for instructions".

"There is a way, don't withdraw from your side for a while, wait for me to do it." Zhou Congwen said, "Small tricks, you will know what to do at a glance."

Director Jiang's curiosity was ignited to the peak.

Liver puncture is a puncture needle that walks in the liver, and even non-doctors know what the liver looks like.This kind of puncture will inevitably bleed, which has nothing to do with technology, but a problem of human physiological structure.

However, the bleeding caused by liver puncture will not be fatal, because the tissue structure in the liver is dense, and the liver puncture needles are very fine, so the bleeding can be stopped quickly.

This summer, China Medical University invited Japanese professors to perform open surgery, TIPS surgery, and the world's top professors had three or four needles before the puncture was successful.

In general surgery, dozens of needles are not enough, and the liver is pierced with needle holes.

but!

Simple puncture is not afraid. Now that thrombolytic urokinase is used, part of this thing must go down the flow, to the portal vein, and then to the punctured sinus.

Even the thrombus that has formed an embolus can be dissolved, let alone the fresh blood in the sinus tract.

If the hemorrhage continues at the liver puncture site, such a particularly successful operation will become a joke in the blink of an eye.

But Director Jiang hesitated for a few seconds, and finally did not question Zhou Congwen's decision.

In doubt, he asked the roving nurse to increase the speed of the micropump to a speed that frightened him.

Zhou Congwen's confident tone made Director Jiang very curious, wondering how this young man would solve the problem.

It was boring while waiting for thrombolysis, Zhou Congwen asked casually, "Professor Wen, what will Chu Han do?"

At this moment, Wen Yuan felt that one of his feet was already in the air, and there was an abyss below him. He said distressedly, "I don't know either."

"Deputy Han protects his weaknesses, especially when he is more supportive of new technologies. I guess it's okay. At most, you will be fined a little money." Director Jiang said, "I had an accident while doing TIPS a while ago, and the hospital helped solve it in the end."

"Oh." Professor Wen sighed.

New technology, it sounds great, and the benefits are right in front of you.

For example, laparoscopic cholecystectomy - the previous laparotomy was at least 15cm, and the larger one required 20cm. The postoperative recovery period of the patient is very long.However, with laparoscopy, only three eyelids were performed, and I was able to go to the ground on the second day, and went home on the third or fourth day.

For example, the TIPS surgery that Director Jiang is thinking about recently - in the past, there was no particularly good way to treat ascites due to cirrhosis, and the surgical operation was extremely risky, and basically one of the two would die.

Because of the high risk, surgery is basically not done.

Therefore, patients in the terminal stage want to be a dead horse as a living horse doctor, which further increases the risk. As a result, the portal azygos shunt surgery with pre-skilled skills has become a rare operation like a giant panda.

TIPS surgery is different. If it is successful after the operation, the effect will be really good!Patients are like normal people, and they can live for at least ten or twenty years.

But this operation is also very risky. It is said that Director Jiang did not establish a channel after wearing 20 needles at that time.

Alas, new technology is really something that makes people scratch their heads.

"Han's office is good." Zhou Congwen said, "With the escort from the hospital, you can have less clinical concerns."

"No matter how little it is, there are risks, and I have to lose a lot of money. Although I didn't pay for it myself, my liver trembled when I heard the amount of money. This is because you are here, and the matter is still controllable; Necrosis, the consequences are disastrous." Wen Yuan said truthfully.

"Even if this is the case, some skills need to be mastered." Zhou Congwen smiled slightly, his eyes narrowed beautifully, "The imperial capital and the magical capital are carrying out similar operations on a large scale. It is estimated that in 3-5 years, laparoscopy When the cystectomy becomes a surgery that must be mastered in hospital.”

"..." Wen Yuan felt a headache when he heard it.

If I lead a group of professors dignifiedly, it will be a joke if I can't compare with the young hospital chiefs of the Imperial Capital and Modu Hospital.

And he himself has developed a deep fear of minimally invasive surgery.

"Let me tell you what time, Professor Wen, you can refer to it." Zhou Congwen said suddenly.

"Huh?" Wen Yuan was taken aback.

"First, intermittent gas decompression during laparoscopic cholecystectomy may be helpful in patients with underlying splanchnic blood flow impairment.

Potential blood flow disorder can generally be defined as the elderly over 70 years old, or it does not matter if the age is further reduced to 60 years old.It may prolong the operation time, but it will be safer. "

Wen Yuan pondered carefully, what Zhou Congwen said seemed to make sense.

"In addition to that, the position is also critical. I feel that head elevation should be avoided as much as possible to prevent further decline in cardiac output, especially in patients with preoperative heart problems."

"This patient is just mesenteric arteriovenous thrombosis. Once a heart attack occurs, it is estimated that he will not be able to wake up in the middle of the night."

"The third..."

While waiting for the thrombolysis, Zhou Congwen began to instill his experience in the previous life.

These experiences are mines that I have stepped on in the operating room of the system.

At that time, I worked so hard to save time for surgical training, but the system declared the operation failed again and again, without telling myself the reason.

Zhou Congwen could only ponder a little bit.

Systematic surgery training time is extremely precious, Zhou Congwen's heart is bleeding every time he fails.

However, he also knows that this is a huge benefit given to him by the system, which allows him to be "naturally" more room for trial and error than other doctors, and does not need to trial and error on real patients.

If such experience is cherished by oneself, doctors like Wen Yuan may not be able to figure out what the problem is all their lives.

In the operating room of the system, Zhou Congwen could only hear the cold mechanical voice announcing the failure of the operation. The result was that part of his time for surgical training was consumed.

But in reality, they have to face the questioning, scolding and even...the death of the patient's family members.

Cherish your broom?

That's what Zhou Congwen thought back then. After all, wouldn't it feel good if a stunt was used to pretend to be a face?

But after meeting the boss, Zhou Congwen gradually understood and followed the boss's principles of life.

Whenever he has the opportunity, he tells others about his experience. Sometimes he even feels that the boss's willingness to speak the truth and instill values ​​comes from this.

Even Zhou Congwen felt that when he got old, he would grumble like a boss and be rejected by young people.

"These twelve points are summed up by the academic circles to avoid complications. Professor Wen, please think about it."

"It's not [-]% avoidable. If you have a better way, you can also tell me, let's study together."

Zhou Congwen said while looking at the surgery area.